Dr Simon Hughes

Urologic oncologist, Consultant Clinical Oncologist , Guy’s and St Thomas’ NHS Foundation Trust
  • London, United Kingdom
  • En
  • Best at: Prostate Cancer, Bladder Cancer

Dr Simon Hughes is Consultant Clinical Oncologist at Guy’s and St Thomas’ NHS Foundation Trust, and an Honorary Senior Lecturer at King’s College London School of Medical Education (GKT Medical School). He specialises in the treatment of Urological cancers: Bladder Cancer, Prostate Cancer, Radiotherapy for other Urological Cancers, SABR/Cyberknife (for Urological cancers). Simon Hughes trained at Guy’s and St Thomas’ Hospitals Medical School, where he also gained a BSc with First Class honours (Anatomy). His specialist training in Clinical Oncology included posts at The Middlesex Hospital, University College London Hospitals, and Guy’s & St. Thomas’ Hospitals. He also spent over 2 years working in the Imaging Sciences Laboratories at Kings College London, and the Centre for Medical Image Computing at University College London developing novel radiotherapy techniques for the treatment of mobile tumours. Simon continues to have an active role in Research and Development. He led the Clinical Oncology and Radiotherapy Research and Development Team at Guy’s and St. Thomas’ Hospitals for 5 years, and was also Radiotherapy Clinical Trials Lead for the South East London Cancer Network during this period. His research interests include tumour motion, radiotherapy dose escalation, integration of functional imaging into radiotherapy planning, and the combination of novel agents with radiotherapy. He is the UK lead for the ENZARAD Study, and is a member of several Trial Management Groups / Data Monitoring Committees. Simon’s other main interest is medical education. He is the Education and Training Lead for King’s Health Partners Comprehensive Cancer Centre; an Associate Clinical Dean at King’s College London School of Medical Education; and is the Clinical Education and Training Lead for King’s College London School of Cancer and Pharmacological Sciences. Nationally, Simon is the Treasurer for the British Uro-oncology Group; and was the co-opted oncologist for the British Association of Urological Surgeons: Oncology Section Committee from 2013-2017. He is also a past President of the Oncology Section of the Royal Society of Medicine (2011-2012), and served on council for over 10 years.

Statistics.

Achievements of Dr Simon Hughes

Trustedoctor credentials
-
Clinical endorsements
27
Articles
171
Scientific
co-authors
Trustedoctor credentials
8
General specialty
10
Subspeciality
Languages

About.

Information about Dr Simon Hughes

Timeline
Place
Country
Position
Focus
2013
The Royal College of Physicians
United Kingdom
Fellowship
2010
University of London
United Kingdom
MD(Res)
2005
The Royal College of Radiologists
United Kingdom
Fellowship
2001
The Royal College of Physicians
United Kingdom
Membership
1997
University of London
United Kingdom
MBBS
Medicine
1994
University of London
United Kingdom
BSc
Anatomy & Basic Medical Sciences
Timeline
Place
Country
Position
Focus
Guy’s and St Thomas’ NHS Foundation Trust
United Kingdom
Consultant Clinical Oncologist
Urologic Cancers
Department of Imaging Sciences, King’s College London
United Kingdom
Honorary Senior Lecturer
Urologic Cancers
Timeline
Place
Organization
Position
-
United Kingdom
British Uro-Oncology Group (BUG)
Treasurer and Trustee
-
United Kingdom
Translational Uro-Oncology Research group
Member
-
United Kingdom
British Medical Association
Member
-
United States
American Society of Clinical Oncology
Member
-
Australia and New Zealand
Australian and New Zealand Urogenital and Prostate Cancer Trials Group
Member
Timeline
Description
Collaboration
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Timeline
Place
Award
Position
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Clinical Experience.

General speciality (5)
Patients per year
Patients total
general prostate tumour oncology
0-100
-
chemotherapy
0-100
-
immunotherapy
0-100
-
targeted therapy
0-100
-
clinical trials
0-50
-
Tumor speciality (7)
Patients per year
Patients total
benign prostatic hyperplasia
0-50
-
acinar adenocarcinoma
0-50
-
ductal adenocarcinoma
0-50
-
advanced prostate cancer
0-50
-
small cell prostate cancer
0-50
-
squamous cell cancer
0-50
-
transitional cell carcinoma
0-50
-
Techniques (2)
Patients per year
Patients total
stereotactic ablative radiotherapy (sabr)
0-50
-
cyberknife
0-50
-
General speciality (3)
Patients per year
Patients total
general urological oncology
0-100
-
hormone therapy
0-50
-
chemotherapy
0-50
-
Tumor speciality (3)
Patients per year
Patients total
bladder cancer
0-100
-
penile cancer
0-50
-
testicular cancer
0-50
-
Techniques (2)
Patients per year
Patients total
stereotactic ablative radiotherapy (sabr)
0-50
-
cyberknife
0-50
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Skills & Endorsements.

General specialty
general prostate tumour oncology
chemotherapy
immunotherapy
targeted therapy
Techniques
stereotactic ablative radiotherapy (sabr)
cyberknife
volumetric modulated arc therapy (vmat)
General specialty
general urological oncology
hormone therapy
chemotherapy
Techniques
stereotactic ablative radiotherapy (sabr)
cyberknife

Academic research.

27
Total articles
  • surgery - 8
  • radiotherapy - 4
  • chemotherapy - 10
8
prostate cancer articles - Impact Factor
  • prostate neoplasms - 8
  • oncology therapy - 8
Management of Prostate Cancer in Elderly Patients: Recommendations of a Task Force of the International Society of Geriatric Oncology.

Prostate cancer is the most frequent male cancer. Since the median age of diagnosis is 66 yr, many patients require both geriatric and urologic evaluation if treatment is to be tailored to individual circumstances including comorbidities and frailty.

Complexity of FGFR signalling in metastatic urothelial cancer.

Urothelial cancers (UC) are the fourth most common tumours worldwide after prostate (or breast), lung and colorectal cancer. Despite recent improvements in their management, UC remain an aggressive disease associated with a poor outcome. Following disease progression on first-line platinum-based chemotherapy, very few effective treatment options are available and none of them have shown significant improvement in overall survival. Alterations of the fibroblast growth factor receptor (FGFR) pathway including amplification, mutations and overexpression are common in UC. Pre-clinical data suggest that the presence of such dysregulations may confer sensitivity to FGFR inhibitors.

Management of prostate cancer in older patients: updated recommendations of a working group of the International Society of Geriatric Oncology.

In 2010, the International Society of Geriatric Oncology (SIOG) developed treatment guidelines for men with prostate cancer who are older than 70 years old. In 2013, a new multidisciplinary SIOG working group was formed to update these recommendations. The consensus of the task force is that older men with prostate cancer should be managed according to their individual health status, not according to age. On the basis of a validated rapid health status screening instrument and simple assessment, the task force recommends that patients are classed into three groups for treatment: healthy or fit patients who should have the same treatment options as younger patients; vulnerable patients with reversible impairment who should receive standard treatment after medical intervention; and frail patients with non-reversible impairment who should receive adapted treatment.

Is there an antiandrogen withdrawal syndrome with enzalutamide?

To examine prostate-specific antigen (PSA) levels after enzalutamide discontinuation to assess whether an antiandrogen withdrawal syndrome (AAWS) exists with enzalutamide.

Evolution of the treatment paradigm for patients with metastatic castration-resistant prostate cancer.

As recently as 2004, treatment options for men with metastatic castration-resistant prostate cancer (mCRPC) were limited, with docetaxel the only approved agent conferring a survival benefit. The therapeutic landscape is now very different, with several agents demonstrating prolonged survival since 2010. New agents for the treatment of mCRPC include sipuleucel-T, cabazitaxel, abiraterone acetate, enzalutamide and radium-223. All are now approved for use in this patient group, although the specific licensing terms vary between agents. In addition, denosumab may have utility in patients with bone metastases. A number of novel agents are also in development with promising initial results. However, because these treatment options have proliferated rapidly, there is currently a paucity of clinical evidence regarding their optimal sequencing. Selection of an appropriate treatment option should take into consideration disease characteristics, drug availability and patient choice. In summary, we discuss several new treatment options available for mCRPC and their integration into the current treatment paradigm.

Radical radiotherapy for high-risk prostate cancer in older men.

Historical data for older men with high-risk nonmetastatic prostate cancer treated with radiotherapy alone have demonstrated a 10-year prostate-cancer-specific mortality of around 30%. The development of dose escalation, using techniques such as intensity-modulated radiotherapy, has enabled more targeted delivery of treatment with improved efficacy and a reduction in the risk of toxicity compared with conventional radiotherapy. The combination of radiotherapy and androgen-deprivation therapy (ADT) has been shown to improve overall survival compared with radiotherapy or ADT alone without a significant increase in toxicity in patients with minimal comorbidities. There is evidence that patient age has only a marginal effect on genitourinary and gastrointestinal toxicities following radiotherapy. Further research has shown that although age does have an effect on the likelihood of sexual dysfunction after radiation therapy, there is no significant difference in the proportion of men aged ≥ 75 years who feel that sexual dysfunction is a moderate or serious problem before or 24 months after diagnosis. Radical radiotherapy is effective and well tolerated in senior men with high-risk prostate cancer and should be offered in combination with long-term ADT to patients with minimal comorbidities. In case of significant comorbid conditions, shorter durations of ADT may be considered.

7
urological cancer articles - Impact Factor
  • bladder - 7
  • oncology - 7
Phase III, Double-Blind, Randomized Trial That Compared Maintenance Lapatinib Versus Placebo After First-Line Chemotherapy in Patients With Human Epidermal Growth Factor Receptor 1/2-Positive Metastatic Bladder Cancer.

Purpose To establish whether maintenance lapatinib after first-line chemotherapy is beneficial in human epidermal growth factor receptor (HER) 1/HER2-positive metastatic urothelial bladder cancer (UBC). Methods Patients with metastatic UBC were screened centrally for HER1/HER2 overexpression. Patients who screened positive for HER1/2 and who did not have progressive disease during chemotherapy (four to eight cycles) were randomly assigned one to one to lapatinib or placebo after completion of first-line/initial chemotherapy for metastatic disease. The primary end point was progression-free survival (PFS). Results Between 2007 and 2013, 446 patients with UBC were screened, and 232 with HER1- or HER2-positive disease were randomly assigned. The median PFS for lapatinib and placebo was 4.5 (95% CI, 2.8 to 5.4) and 5.1 (95% CI, 3.0 to 5.8) months, respectively (hazard ratio, 1.07; 95% CI, 0.81 to 1.43; P = .63). The overall survival for lapatinib and placebo was 12.6 (95% CI, 9.0 to 16.2) and 12.0 (95% CI, 10.5 to 14.9) months, respectively (hazard ratio, 0.96; 95% CI, 0.70 to 1.31; P = .80). Discontinuation due to adverse events were similar in both arms (6% lapatinib and 5% placebo). The rate of grade 3 to 4 adverse events for lapatinib and placebo was 8.6% versus 8.1% ( P = .82). Preplanned subset analysis of patients strongly positive for HER1/HER2 (3+ on immunohistochemistry; n = 111), patients positive for only HER1 (n = 102), and patients positive for only HER2 (n = 42) showed no significant benefit with lapatinib in terms of PFS and overall survival ( P > .05 for each). Conclusion This trial did not find significant improvements in outcome by the addition of maintenance lapatinib to standard of care.

Complexity of FGFR signalling in metastatic urothelial cancer.

Urothelial cancers (UC) are the fourth most common tumours worldwide after prostate (or breast), lung and colorectal cancer. Despite recent improvements in their management, UC remain an aggressive disease associated with a poor outcome. Following disease progression on first-line platinum-based chemotherapy, very few effective treatment options are available and none of them have shown significant improvement in overall survival. Alterations of the fibroblast growth factor receptor (FGFR) pathway including amplification, mutations and overexpression are common in UC. Pre-clinical data suggest that the presence of such dysregulations may confer sensitivity to FGFR inhibitors.

Management of Node-Positive Bladder Cancer After Neoadjuvant Chemotherapy and Radical Cystectomy: A Survey of Current UK Practice.

Because of the lack of published evidence, this study was done to explore the decisions and rationale of uro-oncology consultants regarding the treatment of patients with muscle-invasive bladder cancer who have positive lymph nodes after radical cystectomy (RC) and neoadjuvant chemotherapy (NAC).

Prompt diagnosis key in bladder cancer.

Bladder cancer is the most frequently diagnosed cancer involving the urinary tract and is the seventh most common cancer in the UK. Delayed diagnosis is associated with high-grade muscle invasive disease which has the potential to progress rapidly, metastasise and is often fatal. Urothelial cancer (transitional cell carcinoma) is the predominant histological subtype in Europe, where it accounts for 90% of all bladder cancers. Haematuria, which is typically intermittent, frank, painless and at times present throughout micturition, is the classical and most common presentation of bladder cancer. However, irritative symptoms such as dysuria, urgency, urge incontinence and frequency as well as obstructive symptoms can also be experienced. Fatigue; weight loss; anorexia; renal failure; respiratory symptoms and a suprapubic palpable mass are usually signs of advanced or metastatic malignancy. Cigarette smokers have up to four times the risk of bladder cancer compared with non-smokers. Other risk factors include: exposure to aniline dyes; use of cyclophosphamide; history of pelvic radiation; exposure to chemical carcinogens associated with certain industries; spinal cord injuries requiring long-term indwelling catheters; type 2 diabetes treated with pioglitazone and condylomata acuminata. Frank haematuria has a high diagnostic yield for malignancies involving the urinary tract and initial routine tests should be directed towards identifying a variety of potential non-malignant causes. A thorough physical examination should be undertaken to identify evidence of bleeding diathesis and metastatic malignancy. Suggested laboratory investigations include FBC, coagulation, creatinine and PSA. The diagnosis of bladder cancer is based on urine cytology, cystoscopy and pathological assessment of the bladder biopsy.

Role of fluorodeoxyglucose positron emission tomography (FDG PET)-computed tomography (CT) in the staging of bladder cancer.

To determine whether to use (18) F-fluorodeoxyglucose positron emission tomography (FDG PET) scans in the preoperative staging of bladder cancer (BC).

Second-line chemotherapy for advanced bladder cancer: a survey of current UK practice.

To understand current practice of the treatment of advanced bladder cancer in the United Kingdom, and in particular, the use of second-line chemotherapy.To gain insight into uro-oncologists' use of first-line chemotherapy, imaging following first-line chemotherapy, use of second-line chemotherapy, and the role of the multidisciplinary tumor board (MTB) in making decisions about second-line chemotherapy.

Connections.

Map of connections

171
Scientific
co-authors
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